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Trauma Centers

It is maybe the most American consideration. It is even in our national philosophy. It is the maxim that all men (people) are created equal. It certainly is what we aspire to socially.

You note, they don’t say equally. That makes sense. I mean, if I live to be a million-years-old I will never as fast as Usain Bolt. Actually, if I live to be a million, I probably won’t run as fast as most people.

In terms of being equal, the same consideration could be applied to hospitals. In the United States most hospitals are able to provide a basic level of care. It’s when you start to consider specialty care, especially trauma, cardiac care, stroke care, pediatrics and burns that hospitals and what they can do differ dramatically.

Let’s start with trauma. Trauma care goes back as far as the first altercation, and it often is what we think of when we talk about emergency care. You get a cut. You have a car accident. You are bitten by a snake. You go to the hospital. The truth is that hospital care when it comes to trauma varies tremendously. The quality of care and how well you survive, and your quality of life later on may also vary depending on where you go. This all depends on the training and specialties of the doctors and nurses, and the equipment and the support services, like the intensive care units that are immediately available. Not every hospital is the same.

To understand this and help identify the level of care available in an area, most states have established criteria and designations for varying types of care. The tricky thing is understanding what that means. Many states have adopted the American College of Surgeons (ACS) standards for classifying levels of trauma care.

Classification and Designation. Those words seem interchangeable, and many people use them interchangeably, but they aren’t. Classification often speaks to criteria and is a professional term. It means that based on some standard established somewhere the hospital has measured up. That could be by a professional organization or care coalition like the ACS or the Joint Commission (JC.) It doesn’t have legal authority. It draws on the expertise of specialists and medical experts. It is often adopted by legal authorities or Authorities Having Jurisdiction (AHJ) like the state.

So, this concludes the civics lesson. What all this means is that words matter. It also means that it pays to understand what those words mean when you are seeking trauma care, or of someone you love is in the hospital and you aren’t quite sure if they are getting the best care and should be transferred.

Can’t I just rely on the ambulance to take me to the best place? I n many cases yes. Then again, sometimes no. Emergency Medical Services (EMS) often has a lot to consider in delivering a patient. If the system is stressed, they may transport you to a facility that they think can stabilize and then transfer you. That isn’t always feasible. It is also not always quick. In trauma how quickly you get care can make a big difference. In some states you have no choice. In some states you are even asked where you want to go. Regardless, you want to know where the best level of care is located.

So how do you know? It used to be tough. In some states they designate based on an inverse numeric categorization. Level 1 is the highest and includes all care that can be applied immediately (neurosurgery, chest surgeons, orthopedics, anesthesiologists, ICUs) with attending physicians and residents on premises. A Level 2 is slightly lower, often providing everything but neuro. A level 3 is where things often get murkier, with different criteria applied, often within the same state, and Level 4s and below are even less clearly defined. That means that you really have to dig around online to know.

In some states they even use different language to classify and designate.

So how can you advocate for yourself or a loved one? Well now there is an app for that. Minson’s Guide to Specialty Hospitals is now available for regional or national use at the Apple App Store and Googleplay.

All you have to do is download, subscribe and start using it. Then no matter if you need cardiac, stroke, trauma , pediatric or other specialty care, you’ll be able to make the call as you travel, relocate, or add members to your household


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